Video laryngoscopy for assisting tracheal intubation is a commonplace medical procedure alongside traditional direct view laryngoscopy and indirect view laryngoscopy using optical view tubes. Tracheal intubation can be further facilitated by the use of a video stylet in conjunction with a video laryngoscope.
Video laryngoscopy includes a handheld video laryngoscope and a display screen for instantaneously displaying an anatomically defined sequence of progressively imaged physiological structures during the manipulation of a laryngoscope blade from an initial blade insertion into a patient's mouth to a final blade position for assisting tracheal intubation. The anatomically defined sequence of progressively imaged physiological structures includes the following intubation significant landmarks: (1) the tongue and uvula, (2) the epiglottis, (3) the posterior cartilages and interarytenoid notch, (4) the glottic opening, and (5) the vocal cords.
Challenges often arise to hinder recognition of progressively imaged physiological structures. For example, recognition of the epiglottis may be hindered owing to its visual similarity to the mucosa of the posterior pharynx, and accumulation of blood, secretions, and/or vomitus in the posterior pharynx. Improper identification of certain landmarks can lead to errors in intubations. For example, if the esophagus and glottic opening are confused, esophageal, rather than tracheal, intubation may occur.
US Patent Application Publication No. US 2012/0190929 to Patel et al. (hereinafter the Patel disclosure) discloses a laryngoscope including a handle, a blade holding element, a detachable blade, means for viewing the laryngeal inlet of a patient and means for adjusting the viewing field. The Patel disclosure discloses the laryngoscope is configured to be usable with at least two different detachable blades including inter alia straight blades, curved blades, and so-called difficult intubation blades.
Patel paragraph [0013] discloses a blade holding element with a multi-camera system including two adjacent fixed cameras directed to two different viewing fields and intended to be used with different blades. Patel paragraph [0013] also discloses means for switching from one camera to the other so that a clinician may select to use the first camera for when the laryngoscope is fitted with a standard blade and the second camera when a difficult intubation blade is used.
Patel paragraph [0014] discloses a blade holding element with a single movable or tiltable camera and mechanical or electronic means for remotely changing the position of the camera for positioning in a desired position to provide a clear, non-distorted view of a patient's laryngeal inlet.
U.S. Pat. No. 5,800,344 to Wood, Sr. et al, (hereinafter the Wood disclosure) discloses a video laryngoscope having an image sensor assembly mounted thereon for providing video imaging of a patient's airway passage. The Wood disclosure discloses a fixed position image sensor and an image sensor assembly slidably mounted on a track formed on a curved section of a laryngoscope body so that sliding of the image sensor assembly along the track adjusts the distance of the assembly from a target and the orientation angle of the image sensor assembly.
U.S. Pat. No. 8,398,545 to Chen et al. (hereinafter the Chen disclosure) discloses a video laryngoscope with a movable image capturing unit similar to the Wood disclosure. The Chen disclosure discloses a laryngoscope with a side mounted display and also a laryngoscope with an external display for reducing the volume and size of the laryngoscope.
U.S. Pat. No. 8,652,033 to Berci et al. (hereinafter the Berci disclosure) discloses a video intubation system that provides multiple streams to be simultaneously presented to a user. A video laryngoscope provides a first image stream and a video stylet provides a second image stream. The two image streams may be presented to the user on two different side-by-side monitors or a single monitor provided with a split screen. The video intubation system presents a user with a view of the upper portion of a patient's anatomy via the laryngoscope as well as being presented with a view in front of the video stylet as the stylet is advanced through the trachea.
US Patent Application Publication No. US 2011/0263935 to Qiu (hereinafter the Qui disclosure) discloses an intubation system for intubations based on an airway pattern indicating a trachea opening. The airway pattern is determined from analysis of airway data detected by a trachea identifying device disposed on a movable guide stylet of the intubation system. Qui FIG. 4 shows a guide stylet 46 with light sources 62, image capture devices 64a and 64b on either side of a laser pointer 70, gas exchange detectors 66 and control cable 68. Qiu para [0050] discloses the image capture devices may be a video camera to continually capture images or a still camera to capture still images. In another example, the image capture devices may be a thermal camera or an infrared camera to capture thermal images.
US Patent Application Publication No. US 2012/0116156 to Lederman (hereinafter the Lederman disclosure) discloses a medical device includes a tube, at least one imaging sensor coupled to an endoscope in the tube, and a monitor application to monitor positioning of the tube in a medical patient by identifying expected anatomical features in images provided by the at least one sensor. The Lederman disclosure also discloses a method for endotracheal intubation including receiving imaging frames from a sensor located in an endotracheal tube inserted through a patient's and processing the image frames to identify progression of anatomical features consistent with a proper placement of the endotracheal tube. In particular, the Lederman disclosure discloses image processing to identify vocal cords, trachea, the esophagus, carina, and the like.